Provider Demographics
NPI:1821555632
Name:KELSCH ASSOCIATES INC. NEW JERSEY
Entity Type:Organization
Organization Name:KELSCH ASSOCIATES INC. NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PS SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-456-2022
Mailing Address - Street 1:368 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WESTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08093-1193
Mailing Address - Country:US
Mailing Address - Phone:856-456-2022
Mailing Address - Fax:856-456-4372
Practice Address - Street 1:1000 BROADWAY APT 113
Practice Address - Street 2:
Practice Address - City:WESTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08093-1438
Practice Address - Country:US
Practice Address - Phone:856-456-2022
Practice Address - Fax:856-456-4372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities